School completion and progression to higher education in adolescents with social anxiety: a linkage between Young-HUNT3 and national educational data (2008-2019), Norway.

BACKGROUND: Social anxiety disorder (SAD) most commonly develops in adolescence-a period of life that includes a transition to upper secondary school. The aim of this study is to investigate the extent to which social anxiety in adolescence is associated with the completion of upper secondary school and progression to higher education. METHODS: This longitudinal study includes 8,192 adolescents aged 13-19 years who participated in the Norwegian Young-HUNT 3 population-based study. Social anxiety is measured employing (1) diagnostic interview screening questions (interview) and (2) a self-reported symptom index (questionnaire). Notably, we define the cohorts based on these two methods. Using national educational data (2008-2019), we follow educational attainment among the cohorts until they turn 25 years of age. RESULTS: We found that adolescents who screened positive (SP) for SAD had a predicted probability of upper secondary school completion at 21 years of age that was 14% points lower than those who screened negative (SN). Further, differences remained when looking at completion rates at age 25 years. Moreover, predicted probabilities for completion were inversely associated with increasing levels of self-reported social anxiety symptoms. Similarly, the proportion of the completers of an academic program in the SP group that were enrolled in higher education by 25 years of age, were lower than for the SN group (87 vs. 92%). CONCLUSION: Social anxiety in adolescence, both self-reported symptoms and diagnostic screening, has long-term negative impact on upper secondary school completion and to some extent enrollment to higher education.

Corrigendum: School functioning and educational aspirations in adolescents with social anxiety-The Young-HUNT3 study, Norway.

[This corrects the article DOI: 10.3389/fpsyg.2021.727529.].

Corrigendum: Sociodemographic correlates and mental health comorbidities in adolescents with social anxiety: the Young-HUNT3 study, Norway.

[This corrects the article DOI: 10.3389/fpsyg.2021.663161.].

School Functioning and Educational Aspirations in Adolescents With Social Anxiety-The Young-HUNT3 Study, Norway.

Social anxiety disorder (SAD) typically emerges during childhood or early adolescence and often has long-term effects on several areas of an individual's life, including school and education. The purpose of this study is to examine whether social anxiety is associated with (1) school functioning in terms of behavioral difficulties (hyperactivity and/or attention problems), school dissatisfaction, social exclusion, truancy, and learning difficulties, and (2) educational aspirations (educational level). We use data from the population-based Young-HUNT3 study (2006-2008), where 8,199 Norwegian adolescents participated. Social anxiety is measured both as self-report [the Social Phobia and Anxiety Inventory for Children (SPAI-C)], and as screening information from diagnostic interviews [Anxiety Disorder Interview Schedule for DSM IV: child version (ADIS-C)]. ADIS-C screening positives (n = 388) reported higher rates of behavioral difficulties (RR = 1.06), school dissatisfaction (RR = 1.15), social exclusion (RR = 1.24), truancy (RR = 1.05), and learning difficulties (RR = 1.10) compared to screened negatives. Self-reported social anxiety symptoms showed similar patterns. Further, higher mean scores of self-reported social anxiety symptoms and being ADIS-C screening positive were negatively associated with aspirations of higher education (OR = 0.92 and OR = 0.74, respectively). However, as regards to having aspirations for the future (aspirations of higher education and/or aspirations of vocational training), no associations were found. The results indicate that social anxiety in adolescence is related to unfavorable/poorer school functioning and lower tendency of aspirations of higher education, which may have consequences for future educational pathways and later work life.

Psychological distress in late adolescence: The role of inequalities in family affluence and municipal socioeconomic characteristics in Norway.

The present study aims to explore, in the national context of Norway, how municipal socioeconomic indicators affect anxiety and depressive symptom scores among senior high school students and whether this potential municipal effect is dependent on the adolescents' family affluence levels. This cross-sectional study is based on questionnaire data collected in five waves (2014-2018) of the Ungdata survey. The study sample consisted of 97,460 adolescents aged 16-18 years attending high school in 156 municipalities in Norway. Measures of psychological distress, depression, and anxiety symptoms were based on the screening instrument, Hopkins Symptom Checklist-10. Two-level random intercept models were fitted to distinguish the individual and municipality sources of variation in adolescents' mental health. In general, the results indicate substantial psychological symptom load among the study sample. Inequalities in adolescents' psychological distress between family affluence groups were evident, with the lowest symptom loads in the most affluent families. The predicted depressive and anxiety symptoms among the students increased slightly along with the percentage of municipal residents with tertiary educations and with increasing income inequalities in their residential municipality. However, the interaction models suggest that the adverse effects of higher municipal education level and greater income inequality are, to a certain extent, steepest for adolescents with medium family affluence. This study highlights two key findings. Both municipality effects and family affluence account for a relatively small proportion of the total variance in the students' psychological symptoms loads; however, the mental health inequalities we explored between socioeconomic strata on both the individual and municipal levels are not insignificant in a public health perspective. Results are discussed in the context of psychosocial mechanisms related to social comparison and perceptions of social status that may be applicable in egalitarian welfare states such as Norway.

Sociodemographic Correlates and Mental Health Comorbidities in Adolescents With Social Anxiety: The Young-HUNT3 Study, Norway.

Social anxiety is highly prevalent in adolescents and is often associated with great individual suffering and functional impairment. Psychiatric comorbidity is common and further adds to this burden. The purposes of this study were: (1) to describe the occurrence of diagnosed and self-reported social anxiety among 8,199 Norwegian adolescents aged 13-19 years who participated in the population-based Young-HUNT3 study (2006-2008); (2) to examine associations between sociodemographic characteristics and different subgroups of social anxiety; and (3) to describe the psychiatric health comorbidities among adolescents diagnosed with social anxiety disorder (SAD). In total, 388 (5.9%) of the adolescents screened positive for SAD and were invited into a diagnostic interview, performed by professional nurses, using Anxiety Disorders Interview Schedule for DSM IV: child version (ADIS-C) (response rate = 54.6%). A SAD diagnosis was indicated in 106 individuals (50% of the interview subjects), and more than two-thirds of the adolescents diagnosed with SAD had one or more comorbid psychiatric disorders. Higher mean scores of self-reported social anxiety symptoms, poor self-rated health, sleep problems, poor family economic situation, low physical activity, and having sought professional help within the last year were associated with higher odds of being in the screening positive subgroup. Screening positive subjects who did not meet for a diagnostic interview did not differ notably from the rest of the screening positive group in terms of these sociodemographic characteristics. Based on our results and the fact that individuals with social anxiety often fear interview situations, the use of ADIS-C, screening questions and self-reports seem to be sufficient when aiming to identify epidemiologically representative cohorts of adolescents at risk of social anxiety.

Residential Mobility, Family Structure, and Completion of Upper Secondary Education - A Registry-Based Cohort Study of the Norwegian Adolescent Population.

BACKGROUND: Longitudinal studies exploring the complex interplay between family structures and residential mobility on educational achievement and failure are lacking. We investigate the interplay between the number of residential moves during late childhood, parental education level, family living situation, and the probability of completing upper secondary education. METHODOLOGY: Detailed longitudinal data for a random sample of 30% of the entire Norwegian population born 1982 to 1989 (N = 121,247) and information on all their relocations between Norwegian enumeration districts from ages 10 to 18 years were extracted from the Norwegian population registries. Family structures were grouped into four intersectional family strata defined by combining categories of parental education level (distinguishing poorly educated and well-educated families) and the family's living situation (comparing non-intact families with intact families). We applied two-level logistic regression models, which incorporated individual and family contextual factors, to estimate possible differences in completion rates of upper secondary education. RESULTS: Non-completion of secondary education (which constitutes 29% of the study sample) increases incrementally with the number of residential changes across all four family structures, but this effect was not distributed evenly between the different family strata. Individuals in "well-educated, intact families" seem to be least affected by residential moves. On the other hand, the highest disadvantage of frequent moves was among adolescents in the stratum "poorly educated, intact families." In poorly educated families the probabilities of completing secondary school among non-intact and intact families converge toward each other as the number of moves increase. About 43% of the variation in school completion may be attributed to differences between families. The highest risk of school non-completion was found among adolescents in poorly educated families, which accounted for 74% of the non-completers. CONCLUSION: We demonstrated underlying links between residential mobility and family structures on non-completion of upper secondary education. The adverse effect of frequent moves calls for attention in schools, public health agencies, and housing policies. The findings should be considered in a life course perspective, as the accumulation of unfavorable conditions during childhood and adolescence tends to constrict future prospects in terms of health and quality of life.

Non-completion of secondary education and early disability in Norway: geographic patterns, individual and community risks.

BACKGROUND: School non-completion and early work disability is a great public health challenge in Norway, as in most western countries. This study aims to investigate how medically based disability pension (DP) among young adults varies geographically and how municipal socioeconomic conditions interact with non-completion of secondary education in determining DP risk. METHODS: The study includes a nationally representative sample of 30% of all Norwegians (N = 350,699) aged 21-40 in 2010 from Statistic Norway's population registries. Multilevel models incorporating factors at the individual, neighbourhood and municipal levels were applied to estimate the neighbourhood and municipality general contextual effects in DP receipt, and detect possible differences in the impact of municipal socioeconomic conditions on DP risk between completers and non-completers of secondary education. RESULTS: A pattern of spatial clustering at the neighbourhood (ICC = 0.124) and municipality (ICC = 0.021) levels are clearly evident, indicating that the underlying causes of DP receipt have a systematic neighbourhood and municipality variation in Norway. Non-completion of secondary education is strongly correlated with DP receipt among those younger than 40. Socioeconomic characteristics of the municipality are also significantly correlated with DP risk, but these associations are conditioned by the completion of secondary education. Living in a socioeconomically advantageous municipality (i.e. high income, high education levels and low unemployment and social security payment rates) is associated with a higher risk of DP, but only among those who do not complete their secondary education. Although the proportion of DPs was equal in rural and urban areas, it is evident that young people living in urban settings are more at risk of early DP than their counterparts living in rural parts of the country when controlling for other risk factors. CONCLUSION: The association between school non-completion and DP risk varies between municipalities and local socioeconomic environments. The interplay between personal characteristics and the local community is important in DP risk among young adults, implying that preventive measures should be directed not only at the individual level, but also include the educational system and the local community.

Disability Pensions Among Young Adults in Vocational Rehabilitation.

OBJECTIVES: Lack of work-participation and early disability pensions (DP's) among young adults are increasing public health problems in most western European countries. The present study investigated determinants of early DP in young adults in vocational rehabilitation. METHODS: Data from 928 young adults (aged 18-40 years) attending a vocational rehabilitation program was linked to DP's recorded in the Norwegian Labor and Welfare Organization registries (1992-2010) and later compared to a group of 65 employees (workers). We used logistic regression to estimate the odds ratio for entitlement to DP following rehabilitation, adjusting for socio-demographical, psychosocial and health-behavior factors. RESULTS: Significant differences in socio-demographical, psychosocial and health-behavior factors were found between the rehabilitation group and workers. A total of 60 individuals (6.5%) were granted a DP during follow-up. Increase in age, teenage parenthood, single status, as well as low education level and not being employed were found to be the strongest independent determinants of DP. CONCLUSION: Poor social relations (being lone), early childbearing and weak connection to working life contributed to increase in risk of DP's among young adults in vocational rehabilitation, also after adjusting for education level. These findings are important in the prevention of early disability retirements among young adults and should be considered in the development of targeted interventions aimed at individuals particularly at risk of not being integrated into future work lives.

[Utilization of diagnostic tools and health care services for obstructive lung disease]. / Utvikling i diagnostisering og helsetjenesteforbruk ved obstruktiv lungesykdom.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) has been under-diagnosed and the patients are commonly misdiagnosed as having asthma. Due to the lack of recent data on Norwegian COPD diagnoses, we wished to assess the development of diagnosing and treating COPD and asthma in Norway. MATERIAL AND METHODS: We identified patients with an ICPC-diagnosis of COPD and/or asthma at eight primary health care centres in Norway, 1995 - 2004. Data on prescription of medical drugs, spirometry testing, visits to casualty/outpatient clinics, and hospitalization were retrieved from electronic sources. RESULTS: The diagnosis COPD was used increasingly over the study period, while the the use of the asthma diagnosis declined in the oldest age-groups. The proportion of COPD patients tested with spirometry increased from 24 % (68/288) in 1995 - 96, to 41 % in 2003 - 04. 16 % of COPD patients were in contact with out-of-hours services, 19 % had an outpatient consultation, and 24 % were hospitalized the same calendar year as the diagnosis was given in general practice. Corresponding numbers for asthma patients were substantially lower. INTERPRETATION: The increased use of the COPD diagnosis indicates improved diagnostic routines, probably because of increased use of spirometry in primary care. Early and correct diagnosis contributes to more optimal use of medication and improved follow/up.

A randomized trial on the clinical performance of Nova T380 and Gyne T380 Slimline copper IUDs.

PURPOSE: The objective of this open randomized study was to compare the clinical performance of Nova T380 and Gyne T380 Slimline copper intrauterine devices (IUDs). MATERIALS AND METHODS: Eligible for analyses were 957 Norwegian parous women aged 18-45 years. Clinical performance was measured upon the removal of IUD due to contraceptive failure, expulsion, bleeding, pain, pelvic inflammatory disease and other medical reasons during a 5-year study period. RESULTS: The discontinuation rate due to contraceptive failure was significantly higher in the first year for Nova T380 users than for Gyne T380 Slimline users, whereas no differences were observed thereafter (the 5-year cumulative failure rates were 4.4% and 2.2%, respectively, per 100 women). However, the partial expulsion rate was significantly higher in the first year for Gyne T380 Slimline users than for Nova T380 users (the 5-year cumulative rates were 3.4% and 1.1,% respectively, per 100 women). No other major differences in reasons for discontinuation were found between the study groups. There was a slight nonsignificant increase in hemoglobin levels for both study groups over the course of the study. CONCLUSION: Clinical performance was considered satisfactorily high for both devices.